METHODS: This case report focuses on a 12-year-old Middle Eastern boy who presented with hematochezia and abdominal pain for a couple of days. A tagged Red blood cell (RBC) scan and Technetium scan revealed gastrointestinal bleeding at the lower abdomen, highly suggestive of the diagnosis of Meckel\'s diverticulum. Subsequently, exploratory laparotomy revealed contiguous and scattered mucosal lesions with multiple polyps of various sizes in the terminal ileum. Meckel\'s diverticulum was absent, and the patient was treated with resection and primary anastomosis. The resected tissue revealed extensive ectopic gastric mucosa and polypoid tissues. The patient recovered uneventfully and was discharged four days after the surgery. The symptoms did not recur within six months after his surgery.
CONCLUSIONS: Our case demonstrated that despite the rarity of multiple polypoid gastric heterotopias in the terminal ileum, it should be considered as one of the differential diagnoses of gastrointestinal tract bleeding.
方法:本病例报告集中于一名12岁的中东男孩,他出现了几天的便血和腹痛。标记的红细胞(RBC)扫描和Tech扫描显示下腹部胃肠道出血,高度暗示诊断为Meckel憩室。随后,剖腹探查术显示回肠末端有连续和分散的粘膜病变,并有各种大小的多发性息肉。Meckel的憩室不存在,患者接受了切除和一期吻合治疗。切除的组织显示广泛的异位胃粘膜和息肉样组织。患者恢复顺利,手术后四天出院。手术后六个月内症状没有复发。
结论:我们的病例表明,尽管在回肠末端有多个息肉样胃异位症,应作为消化道出血的鉴别诊断之一。